Theme: Clinical Research Year: 2022
Background:
< In previous studies we have analyzed drug-drug interactions (DDIs) in the general population. In
this sub-analysis we focus on patients with addiction to substance or drug abuse. The objective is to
describe the drug use, comorbidities, comedication, the associated risk of DDIs and the potential
outcome.>
Methods:
< Retrospective observational study, obtained from the BIG-PAC database (Atrys Health), on HCV
patients (pts) treated between 2017 and 2020. Possible DDIs with direct-acting antivirals (DAAs)
(Sofosbuvir/Velpatasvir [SOF/VEL] and Glecaprevir/Pibrentasvir [GLE/PIB]) were evaluated using the
University of Liverpool Interactions for Hepatitis database. Potential outcome of DDIs: increase (↑)
in comedication concentration or ↑ DAA (possible impact on safety) and decrease in DAA, ↓DAA
(possible impact on efficacy).>
Results:
<985 pts with history or current consumption of abuse and recreational substances were included,
450 for SOF/VEL (mean age: 53 years; men 65%; F3/4 42%) and 535 with GLE/PIB (mean age: 50
years; men 65%, F3/4 30%). Regarding consumed substances there was higher consumption of
opioids in pts treated with SOF/VEL vs GLE/PIB (13% vs 9%, p <0.05, respectively).
The most prescribed drugs belonged to nervous system (40%); anti-infectives for systemic use,
(13%); cardiovascular (12%) and alimentary system (12%).
GLE/PIB presented a higher percentage of potential DDIs than SOF/VEL, with nervous system
medication (8.5% vs 4.9%, p <0.01) and cardiovascular (36.8% vs 13.7%, p <0.001); and similar for
alimentary system (45.4% vs 44.7%, ns) and anti-infectives (5.8% vs 6.9%, ns). The most prescribed
nervous system drugs with potential DDIs were quetiapine and metamizole.
9% (68) of pts with ≥2 comedications presented multiple DDIs (≥2 potential DDIs with DAAs): 30 pts
for SOF/VEL and 38 pts for GLE/PIB.>
Conclusion:
< in Spain, 9% of HCV patients with addictions to abuse or recreational substances taking ≥2
comedications are at risk of multi-DDIs. >
Disclosure of Interest Statement:
See example below:
Speaking/consulting/research: JT (AbbVie, Gilead Sciences, MSD), AGH (AbbVie, Gilead Sciences), RM
(AbbVie, Gilead Sciences, Janssen, MSD, ViiV Healthcare), ASM (Atrys Health employee). Gilead
employees: MM, CdA and CH. This study was funded by Gilead Sciences.